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INTEROFFICE MEMORANDUM Maricopa County Education Service Agency (aka Maricopa County Superintendent of Schools Office) TO: CLERK OF THE BOARD FROM: Terri Ysaguirre SUBJECT: Affidavits — Replacement of Lost Warrants DATE: 3/29/2019 Please find attached 1 Affidavit/Notice of Claim(s) for lost warrants for inclusion on the next available Board agenda V The attached item(s) have been researched to ensure that the warrant(s) in question have not been cashed or previously re-issued. V The original warrant(s) have had a stop payment done. If you have any questions, please contact Terri Ysaguirre at 602-372-1245 or via e-mail at terri.ysaguirre@mcesa.maricopa.gov . Approved Affidavits may be routed back to the Superintendent of School Finance Division at 4041 N. Central Avenue #1200, (12th Floor) Thank you. #60 Higley Unified Prestige of Rite of Passage $17,926.00 RECEIVED MAR 2 9 2019 CLERKmARIcopi, couNTY BOARD OF SUPER VIsORS 7C-j Cfr Schools Affidavit/Claim Form Application for a Duplicate Warrant/Check (definitions are on page 2) STATE OF ARIZONA Note: Numbers on this form correspond to numbers on the COUNTY OF MARICOPA Instruction sheet which is page 2 of this form. Prestige of Rite of Passage (1), being first sworn, upon oath deposes and says: Name/Claimant On or about 11/29/2018 (date)(2) a warrant/check was issued to the above named person/entity in the amount as stated below. Such warrant/check was either never received or was subsequently inadvertently lost or destroyed and there is no reasonable probability of its being found or presented for payment, or it was not presented for payment within one year after the date of issuance. Therefore, under penalty of perjury, claimant hereby affirms that this claim is correct and the amount shown is due and owing, and the applicant requests that a replacement warrant/check be issued to him/her in the sum of $ 17,926.00 .(3) Signed: ncA..,A-A__, (4) (5) Subscribed and sworn to before me this day of r( editiA, 20 19 . MARGARET M BOYER NOTARY PUBLIC ) STATE OF NEVADA My commission expires: Appt. No. 16- 1965 - 12 /4 / 2,6) 24) My Appt. Expires March 4, 2020 (seal) Note: Please attach a copy of the warrant/check if available and/or any other evidence that a warrant/check was originally issued, Warrant/Check Number 3700116256 (if known) (6) Original Date of Issue 11/29/2018 (if known) (7) i Reason for original issue of Warrant/Check (8): Payroll 141 For Services or Goods furnished Day School lii Other: S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools\Schools-Warrants Checks notice of claim.doc Revised June 2015 A.R.S. 11-632 & 15-999 March 4, 2019 Higley Unified School District 2935 S Recker Rd Gilbert, AZ 85142 Attn: Lisa Bate Hello Ms Bate, This is in regard to the affidavit for the check lost in the mail made payable to Rite of Passage in the amount of $17,926.00. This affidavit is signed by Lone Fox, A/R Supervisor and she is authorized to sign it. Kristy Crandell Lead Accounts Receivable Clerk 775-392-2657 RITE OF PASSAGE, INC. "Dedicated to improving the lives ofyouth, families and communities." 2560 BUSINESS PARKWAY, SUITE A I MINDEN, NV 89423 I 775-267-9411 I FAX 775-267-9420 I WWW.RITEOFPASSAGE.COM